Ever since 2012, the Bergen based organisation The Ethiopia Fund has yearly funded 150 fistula surgeries at the fistula centre in Asella, Ethiopia.

Dangerous complications

Obstetric fistulas mainly occur in young, poor women living in rural areas without access to medical assistance during childbirth. Complications arise if the baby gets lodged pressing against the pelvic tissue. This halts blood flow to the area and leads to tissue death.

“You then get a hole, most often between the vaginal canal and the bladder or intestine, and urine, faeces, or both leaks through,” explains Anna Berge Pedersen, founder of The Ethiopia Fund. She works as a midwife at Haukeland University Hospital in Bergen.

Usually the child dies. After, the smell from the leakage causes great problems for the woman. Many are cast out by their family and community.

“In this way, the social exclusion adds to the burden they are already carrying of physical strain and grief,” says Anne Berge Pedersen.

Social exclusion

Unfortunately, the surgery is usually not enough. Even after a successful procedure, it takes a long time to overcome the consequences of having been excluded by their community for such a long time.

“Returning to their lives is not a given,” says Anne Berge Pedersen.

For this reason, it is also important to help the women reintegrate into their communities after surgery. Effective measures can be psychological counselling, advice on potential new pregnancies and childbirth, and vocational training to ensure they can support themselves economically.

“The Ethiopia Fund´s great dream has for a long time been to get involved in this aspect as well. Now, with the support from the Kavli Trust, we´re realising this dream,” says Anne Berge Pedersen.

The Kavli Trust is contributing 1,16 million NOK from 2018 to 2020. The board of the Ethiopia Trust oversees the project on a volunteer basis.

A new beginning for 50 women

Through a three-year project, 50 of the most disadvantaged women treated for fistulas will receive help to start over. Many will be as young as 14-16 years old. They will be given accelerated vocational training, as well as training in production and sales.

“This will grant them better living conditions, increase their standing in the community and ease reintegration. Getting these women reintegrated means they can inform others about the condition, which may also help prevent new fistulas,” says Anne Berge Pedersen.

The recruited women will be divided into groups of ten. These will take part in an accelerated two-month course in different crafts such as weaving, basketry and sowing clothes, purses, tablecloth and shawls.

Vocational training

The women will learn how to sell their own products and agricultural products. They will also receive basic training in reading, writing and maths.

Afterwards, the women spend six months producing their wares under supervision at the reintegration centre, which will also supply materials and resources. The products will be sold at the reintegration centre, in markets, in the city´s hotels and at tourist attractions – all with support from the centre.

After the training programme, the money made will be placed in a joint account. Every group of ten women will have formal ties to a microfinancing programme supported by the country administration.

“In this way, the women will have start-up capital upon leaving the centre, permitting them to continue producing their wares and providing them with an income,” says Anne Berge Pedersen.

Securing longevity

The aim is that the programme will continue to be an important part of the care given to women with obstetric fistulas even after the three-year project period has ended.

“We will achieve this by linking up with the government microfinancing scheme, the regional health care service and the fistula centre at Asella Hospital, and by being a part of the women´s communities and healthcare networks,” says Anne Berge Pedersen.

When the women are reintegrated, they will be ambassadors for the importance of healthcare, pregnancy care and safe childbirth. This can help reduce the occurrence of fistulas and help women suffering from fistulas seek treatment.

“In this way we are contributing to promoting women´s health issues and reducing child mortality.”

Project management

The board of the Ethiopia Fund follows the project closely, on a voluntary basis.

“We oversee that different matters are handled according to the agreements, we have meetings with the surgeons and nurses treating fistulas, and we meet the women affected,” says Anne Berge Pedersen.

“The visits are also very meaningful experiences and we are grateful to take part in the women´s experiences in their new lives, post-surgery.”